What do disability codes mean on a sick leave certificate?

26.06.2019

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4 min.

A sick leave certificate is the main document indicating a previous illness or injury. It is the only basis for calculating insurance payments, the amount of which is established by the accounting department of the enterprise. The information on the forms is presented in such a way that it can only be understood if you have certain knowledge. Sick leave codes and their decoding allow you to make the correct accruals.

Classification of sick leave codes and their decoding

The structure of a sick leave certificate (certificate of incapacity for work, approved by order of the Ministry of Health and Social Development of the Russian Federation dated April 26, 2011 No. 347n) provides for the use of such types of codes as:
1. Codes of the cause of incapacity for work.

There are 15 codes in total for the cause of disability on the sick leave (their decoding is also given in Order No. 347n).

These 2-digit codes are entered in the “Code” cell directly opposite the line “Cause of disability.”

If the original disability code on the sick leave certificate needs to be changed, the new one must be entered in the “Change code” cell, which is located next to it.

2. Additional codes.

They are recorded next to the disability code in certain cases. Namely if:

• the person is undergoing treatment in a sanatorium (in this case, an additional code 017 is entered on the sick leave);
• the employee is undergoing treatment in a sanatorium due to an incident at work (code 018);
• the person is being treated in a clinic belonging to a research organization (code 019);
• the employee is granted additional maternity leave (code 020);
• the employee fell ill due to intoxication or actions related to it (code 021).

3. Codes reflecting family relationships.

They are indicated above the line “Family relationship” if the sick leave is issued for an employee who does not go to work due to caring for a sick family member. In this case, the code must correlate with the one that reflects the cause of disability. If this is code 38, indicating that the employee is a mother and is caring for a child, then code 09 is entered in the line “Cause of disability.”

4. Code reflecting the employee’s violation of the treatment regimen.

Fixed opposite the line “Note about violation of the regime”, if a corresponding violation has taken place. For example, code 24 indicates that a sick employee did not show up for an appointment with a doctor at the appointed time.

5. Other codes.

Indicated opposite the line “Other”. May reflect other significant information about the employee’s health status. For example, if this is code 31, it will mean that the employee has not recovered and is going on new sick leave.

6. Code reflecting the conditions for calculating compensation for sick leave.

Fixed in the line “Accrual conditions”. For example, if a person has already left the company, but fell ill within 30 days after dismissal, code 47 is entered. If necessary, several codes can be indicated in the corresponding line.

Among other significant elements of the document on which compensation for temporary disability is calculated is the subordination code on the sick leave. It, unlike the codes discussed above, is not unified and is set depending on the region of registration of the company in the Social Insurance Fund. You can find out this code from the notice of registration of the employer with this department or by contacting them.

Basic Concepts

A certificate of incapacity for work is an official document that confirms that an employee is undergoing outpatient or inpatient treatment. This is the basis on which payments are calculated, and absence from work is considered valid.

The document is drawn up according to the form that was approved by Order of the Ministry of Health No. 347n dated April 26, 2011. It can be provided in either standard paper or electronic form. The employer’s task is to fill in his part, separated by a transverse line. The main information is entered by the attending physician.

The sheet includes the following information:

• the first is filled out by the doctor;
• the second - by the employer;
• tear-off - drawn up by the doctor, but kept for reporting purposes.

The final section includes the patient's signature. This indicates the transfer of a certificate of incapacity for work. It is necessary to confirm the document has been issued in person.

Attention! The form can be filled out with any pen, except for ballpoint pen. It can be feather, gel, capillary.

Causes of illness and legal consequences for the employer (codes 01, 02, 04)

What is the impact of recording certain codes on the certificate of incapacity in practice? What does sick leave code 01 or 02 mean?

Let's study these issues in the context of the possible legal consequences of indicating certain codes on the certificate of incapacity for work for the employer.

First of all, what specific cause of the employee’s illness is reflected in the sick leave (code “Cause of disability”) may be important:

• One of the most common disease codes on sick leave is 01. It reflects the fact that the employee has contracted a common illness, such as ARVI. If this code is indicated on the sick leave, the employer calculates sick leave compensation in the usual manner established in paragraph 1 of Art. 14 of Law No. 255-FZ.
• In turn, what does sick leave code 02 mean? The fact that the employee suffered an injury not related to work. The presence of sick leave code 02 implies that the employer has the same obligation to calculate the amount of compensation according to the general rules (in particular, taking into account the employee’s length of service).
• The fact of injury at work is reflected on the sick leave using code 04. In this case, the enterprise must pay the employee compensation for sick leave in the amount of 100% of his average earnings (Clause 1, Article 9 of the Law “On Compulsory Social Insurance...” dated July 24, 1998 No. 125-FZ). This is a fundamental difference between the employer’s responsibilities compared to when the cause of incapacity 01 is indicated on the sick leave and the amount of compensation depends on the length of service.

Among the other responsibilities of the employer in the event of an employee’s work-related injury is an investigation of the incident in accordance with the requirements of the Labor Code of the Russian Federation, as well as the rules adopted in local documents. Actually, the presence of code 04 on an employee’s sick leave should not be a surprise to the employer, since it is unlikely that he will not be aware of what happened (and will not take the measures prescribed by the provisions of Articles 228–231 of the Labor Code of the Russian Federation even before the employee returns from sick leave).

But if the company really, for some reason, did not know that the employee was injured as a result of an incident at work, this relieves the employer of responsibility for its investigation, unless the employee applies for an investigation (Article 229.1 of the Labor Code of the Russian Federation).

You will learn more about the rules for calculating sick leave compensation in certain cases from the selection of materials in this section.

Functions of disability codes

Codes have several functions, and protecting medical confidentiality is only one of them:

• optimization of accounting work - payments are calculated based on the numbers entered on the sheet;
• economical filling out of the form, without specifying long medical terms;
• filling out the sheet in accordance with international standards.

So, if the sickness form was opened abroad, the code indicated in it will be the carrier of one information in the territory of any country participating in international legal relations.

Code 11 on sick leave: employer's responsibilities

Other responsibilities may arise for the employer if the disease code on the sick leave certificate is 11. It reflects the fact that the employee suffered the disease specified in clause 1 of the list of socially significant ones, approved. by Decree of the Government of the Russian Federation dated December 1, 2003 No. 715, - tuberculosis.

In this case, the duration of treatment can be up to 12 months (Clause 4, Article 59 of the Law “On the Fundamentals of Health Protection...” dated November 21, 2011 No. 323-FZ), and the employer must be prepared to compensate for it. The maximum duration of treatment in the general case is 10 months (clause 13 of the procedure approved by order of the Ministry of Health and Social Development of the Russian Federation dated June 29, 2011 No. 624n).

In addition, if an employee, along with a sick leave certificate, brings a medical order according to which he will need to be transferred to another position for health reasons, the employer will be obliged to provide such a position or remove the employee from work and pay him temporary disability benefits (Article 73 of the Labor Code of the Russian Federation , paragraph 3 of article 14 of the law “On preventing the spread of tuberculosis” dated June 18, 2001 No. 77-FZ).

Socially significant diseases

In the table we look at socially significant diseases:

What do violation codes mean (23, 24)

Knowing what code 01 means on a sick leave certificate is not enough. It is also necessary to check whether the medical institution has identified other circumstances characterizing the employee’s state of health. Which for example?

Thus, the commonly used sick leave code 01 can be supplemented with a code that gives the employer a basis for reducing the amount of compensation for sick leave. These may be codes that reflect (Clause 1, Article 8 of the Law “On Compulsory Social Insurance...” dated December 29, 2006 No. 255-FZ):

• non-compliance with the prescribed treatment regimen (code 23 in the line “Note about violation of the regimen”);
• failure to appear for a medical examination on time (code 24 in the line “Note about violation of the regime”);
• illness due to intoxication (code 021 in the “Additional code” line).

Sick leave compensation in this case is reduced to the level of the minimum monthly wage:

• from the moment of violation under codes 23 and 24;
• for the entire period of illness using code 021.

Read more about paying sick leave for alcohol intoxication here.

Thus, deciphering the disease code on the sick leave sheet 01, 02, 04 must necessarily be done taking into account the possible presence of the 3 considered codes in the document. Their presence directly affects the size of the company’s obligations for sick leave compensation.

Codes of dangerous diseases

In order to summarize information about the ailments of citizens of different countries, the International Classification of Diseases was compiled and approved. The codes contained in it are recognized by all world states, including Russia.

There are many codes for dangerous diseases; they are not entered on the sick leave sheet, but the presence of one of them is indicated by the code “11” in the line “Cause of illness”.

They are divided into two groups:

• diseases of social significance;
• illnesses that pose a danger to the patient’s environment.

In the table we look at disease codes:

Line “Other” (using code 31 as an example)

In some cases, along with disease codes, information on the line “Other” is recorded on sick leave. For example, code 31, reflecting the fact that the employee did not have time to recover and cannot go to work (the consequence may be the opening of another certificate of incapacity for work).

The fact that the employer received this sheet with code 31 obliges him to pay compensation for it, calculated in the prescribed manner, despite the fact that the employee has not yet returned to work. A sick leave with code 31 is considered closed one way or another. The total number of sheets does not matter: the employer is obliged to pay for each one brought by the employee.

These are the features of deciphering sick leave in cases where the employee himself falls ill. But situations are possible in which it is not he who is sick, but his relative. In this case, a special code is entered on the certificate of incapacity - 09. Let us study what legal consequences its presence on sick leave can create for the employer.

Why is disease coding needed (coding functions)

Main functions of disease coding:

• Maintaining medical confidentiality. If the document is passed from hand to hand, or is accidentally seen by a company employee who looks into the accounting department for his business, you won’t have to worry about third parties knowing about your illnesses. All that people will see is a set of letters and numbers.

• Save space on the form. The sick leave includes a lot of information, because it is filled out by the employer and the health worker, and the information must be complete and useful for both of them. The doctor needs to indicate the details of the paper, information about the clinic and the doctor who saw the patient, information about the sick person and how long he cannot work. It is important for the employer how much to pay the employee from personal money and how much compensation to ask for from the Social Insurance Fund, what length of service the employee has, what is his average salary. This amount of information will take more than one sheet, and the codes are only a few characters, which allows you to limit yourself to the size of the sick leave. Read also the article: → “When sick leave is not paid. 2 examples"

• Optimization and simplification of the work of the personnel service. It is widely known that due to the rush and seeing hundreds of patients a day, doctors tend to write quickly, which often results in illegible handwriting. So it's ironic that deciphering codes takes much less time than deciphering doctors' notes.

• Ensuring the possibility of interaction with foreign hospitals. Disease codes are international, so clinics abroad will be able to understand sick leave records issued in Russia.

• Minimizing errors. By eliminating the need to sort through doctors' notes, the likelihood of errors due to misread notes is reduced to zero.

What does code 09 mean on sick leave: legal consequences for the employer

If an employee’s sick leave is coded 09, this means that he was absent from work due to caring for a child who was sick. Indication of this code in the document implies payment of sick leave in an amount determined in the general manner, as if code 01 or 02 were on the sick leave. As for the number of paid days an employee is on sick leave, it is established taking into account certain provisions of the law.

The duration of paid sick leave for an employee who was absent from work to care for a child is (Article 6 of Law No. 255-FZ):

1. If the child is under 7 years old:

• 90 days a year if the child’s illness is reflected in the list approved by order of the Ministry of Health and Social Development of the Russian Federation dated February 20, 2008 No. 84n;
• 60 days in other cases.

2. If the child is from 7 to 15 years old - up to 45 days a year for all cases of illness (no more than 15 days for each individual case).

3. If the child is under 18 years old:

• up to 120 days if the parent is caring for a child with disabilities;
• without restrictions, if a parent is caring for a child with HIV;
• without restrictions, if a parent is caring for a child who has suffered from vaccination complications or is undergoing treatment for malignant neoplasms.

These rules are the same for employees, regardless of whether their child is a son or daughter, grandson or granddaughter.

IMPORTANT! The specified time restrictions relate specifically to the payment of sick leave, and not to the duration of stay. Read more here.

Common mistakes

Error No. 1: Indicating codes 14, 15 without obtaining the written consent of the child’s parents.

Comment: Codes indicating care for an HIV-infected person who has fallen ill after vaccination or a child who has been diagnosed with a malignant tumor are entered into the form only after receiving written permission from the minor’s parents.

Error No. 2: Filling out the sick leave line starting from the second or subsequent cell.

Comment: The first cell cannot be skipped; the recording must begin with it. This is due to the fact that the information will not be read correctly by the scanner for processing sick leave data.

Application of a new sick leave (by order of the Ministry of Health and Social Development of Russia No. 347n): nuances

It will be useful to consider a number of other nuances that characterize the use of sick leave certificates of the new type by employers (of course, relatively new - they were approved in 2011, but nevertheless they have specifics that should be paid attention to).

First of all, there are a number of formal requirements for filling out a certificate of incapacity for work. So:

• it must be filled with ink, gel, capillary or fountain pen, but not ballpoint;
• characters are not allowed to go beyond the boundaries of document cells;
• characters must be recorded in the document starting from the very first cell.

The sick leave must be certified with a seal that does not appear on certain cells of the document. The fact that, for example, code 02 and not any other is indicated on the sick leave certificate should be obvious to the inspector. In this case, the check can be carried out using a scanner, which will not be able to recognize the code if the seal is layered on the sick leave information field.

The seal of the medical institution must be clear - so that its name is readable (which must coincide with that indicated in the document).

If there are errors in the sick leave certificate or it is filled out incorrectly, the employer must ask the employee to bring a duplicate of the document, filled out taking into account all the requirements.

In Russia, along with paper sick leave, hospitals are increasingly issuing an electronic bulletin. And from 2022, paper sick leave will be abolished. When an employer uploads a document into the system, it has status 030. This means that the sick leave is closed by the medical organization and the employer can work with the document - calculate and pay benefits based on it.

ConsultantPlus experts explained in detail how to organize work with electronic sick leave. If you do not have access to the system, get a trial demo access and go to the Ready Solution to find out all the details of this procedure. It's free.

In what cases is a serial number given?

The sick leave number (sick leave form number) is the twelve digits written on the form. On the sick leave form it is written in two places, on the main part and on the detachable part. The tear-off part remains in the medical institution, and the personnel service employee sees the sheet number on the main part of the form.

The main reason for the appearance of a serial number on the new form of the certificate of incapacity for work is the intention to reduce the possibility of fraud with documentation. On the new forms of certificate of incapacity for work there is no document series, only a serial number.

The number is indicated at the top, on the right in the document. In the white field located under the barcode. The number consists of twelve digits. The first nine digits are ordinal, the last three are check digits.

Results

A sick leave certificate is a document on the basis of which the employer determines, firstly, the amount of compensation for the employee’s temporary disability, and secondly, the duration of paid sick leave. To do this, the various codes recorded on the certificate of incapacity for work are deciphered. When applying sick leave, the employer needs to take into account their correlation.

You will learn more about the peculiarities of using sick leave by employers from the articles:

• “Is sick leave (sick leave) subject to personal income tax?”;
• “Payment for sick leave to care for a sick relative”.

You can find more complete information on the topic in ConsultantPlus. Free trial access to the system for 2 days.

What is temporary disability

Documented reasons or circumstances that officially justify an employee being unable to perform his or her job are called temporary disability.

There are two types of temporary disability:

1. Complete – the impossibility of performing any type of professional activity for a certain period of time, with the need for treatment and the creation of a special regime. It excludes any type of physical and mental stress and provides complete release from obligations to the employer.

1. Partial – the inability to perform one’s direct functional duties at a permanent place of work, but the ability to perform light-duty tasks. In this case, the employee can still perform his duties, but without heavy physical activity or contact with harmful chemicals.

How to pay for two sick days if the first is closed and the second is a continuation of the first?

There are situations when one sick leave has already been closed and the “Get to work” column is filled in, but the employee brings a new open sick leave, which is a continuation of the first one.

For example, if a woman spent 140 days at home during pregnancy and childbirth and closed her sick leave, but then brought a sheet with disability code 05 020, open for 16 days due to complications during childbirth.

In this case, the manager must be guided by Art. 255 of the Labor Code of the Russian Federation and calculate benefits according to the established social amounts.

In the example given, the medical institution initially prepared a sheet on pregnancy and childbirth. If complications occurred during labor, an additional sheet for 16 days was issued for the same insured event. The employer is obliged to pay these two sheets in total, taking as a basis the employee’s average daily earnings in the amount that existed before maternity leave.